Ch 11 Childhood and Neurodevelopmental Disorders

A child diagnosed with attention deficit hyperactivity disorder (ADHD) is reprimanded for taking the nurse's pen without asking first. He responds by shouting, "You don't like me! You won't let me have anything, even a pen!" The nurse is most therapeutic when responding with which statement?

I do like you, but I don't like it when you grab my pen

Cognitive-behavioral therapy is going well when a 12-year- old patient in therapy reports to the nurse practitioner:

I thought that everyone at school hated me. That's not true. Most people like me and I have a friend named Todd.

When group therapy is prescribed as a treatment modality, the nurse would suggest placement of a 9-year- old in a group that uses:

play and talk about a play activity

Which factor presents the highest risk for a child to develop a psychiatric disorder?

Living with an alcoholic parent

Which statement demonstrates a well-structured attempt at limit setting?

"Hitting me when you are angry is unacceptable."

The mother of a 3-year-old boy just diagnosed with autism spectrum is tearful and states, "The doctor said we need to start therapy right away. I just don't understand how helpful it will be—he's only 3 years old!" What response should the nurse provide to the mother's statement?

"Starting him on treatment now gives Taylor a much greater chance for a productive life."

The family of a child diagnosed with attention deficit hyperactivity disorder (ADHD), inattentive type, is told the evaluation of their child's care will focus on symptom patterns and severity. What is the focus of child's evaluation?

-Academic Performance -Activities of Daily Living -Social Relationships -Personal Perception

A 12-year-old male patient diagnosed with Tourette's disorder is visiting his provider. The nurse will prepare medication teaching on which class of medication to help manage the tics associated with this disorder?

-Antianxiety agents -First-generation antipsychotics -Second generation antipsychotics

A nurse prepares to lead a discussion at a community health center regarding childrens health problems. The nurse wants to use current terminology when discussing these issues. Which terms are appropriate for the nurse to use?

-Bullying -Autism spectrum disorder -Intellectual development disorder

In pediatric mental health there is a lack of sufficient numbers of community-based resources and providers, and there are long waiting lists for services. This has resulted in:

-Children of color and poor economic conditions being underserved -Increased stress in the family unit -Premature termination of services

At the time of a home visit, the nurse notices that each parent and child in a family has his or her own personal online communication device. Each member of the family is in a different area of the home. Which nursing actions are appropriate?

-Educate all members of the family about risks associated with cyberbullying -Talk with the parents about parental controls on the childrens communication devices. -Encourage the family to schedule daily time together without communication devices

What assessment question should the nurse ask when attempting to determine a teenager's mental health resilience?

-How did you cope when your father deployed with the Army for a year in Iraq -Who did you go to for advice while your father was away for a year in Iraq? -Where do you see yourself in 10 years?

Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness?

-Limited language skills -Level of cognitive development -Level of emotional development

An 8-year-old patient is newly diagnosed with attention deficit hyperactivity disorder (ADHD). It is important that the parents be educated to the fact that symptoms will take which form? (Select all that apply). of, inattention, and impulsivity have to be apparent:

-Low frustration tolerance -Poor school performance -Impulsive behaviors -Mood Swings

What are the foundational concerns regarding the use of restraint and seclusion when providing care to children?

-Research suggests both are psychologically and physically harmful. -The principle of least restrictive intervention is a primary concern.

A 9-year-old patient has been diagnosed with an intellectual development disorder (IDD). Which assessment findings support this diagnosis?

-Unable to explain the phrase "raining cats and dogs" -Reads below age level -Physically lashes out when frustrated

Pam, the nurse educator, is teaching a new nurse about seclusion and restraint. Order the following interventions from least (1) to most (5) restrictive:

-With the patient identify the behaviors that are unacceptable and consequences associated with harmful behaviors -Offering a PRN medication by mouth -Allowing the patient to take a time-out and sit in his or her room -Placing the patient in a locked seclusion room -Placing the patient in physical restraints

A nurse prepares the plan of care for a 15-year-old diagnosed with moderate intellectual developmental disorder. What are the highest outcomes that are realistic for this patient? Within 5 years, the patient will

-independently perform own personal hygiene. -obtain employment in a local sheltered workshop. -correctly use public buses to travel in the community

Which child demonstrates behaviors indicative of a neurodevelopmental disorder?

A 3-year-old who is mute, passive toward adults, and twirls while walking

A 7-year-old, who is described as impulsive and hyperactive, tells the nurse, "I am a dummy, because I don't pay attention, and I can't read like the other kids." The nurse notes that these behaviors are most consistent with which diagnosis?

ADHD

Which social behavior is often a result of a child having been exposed to some form of abuse?

Bullying others

A nurse works with a child who is sad and irritable because the childs parents are divorcing. Why is establishing a therapeutic alliance with this child a priority

Acceptance and trust convey feelings of security to the child

A child diagnosed with attention deficit hyperactivity disorder will begin medication therapy. The nurse should prepare a plan to teach the family about which classification of medications?

Central nervous system stimulants

Adolescents often display fluctuations in mood along with undeveloped emotional regulation and poor tolerance for frustration. Emotional and behavioral control usually increases over the course of adolescence due to:

Cerebellum maturation

When a child demonstrates a temperament that prompts the mother to say, "She is just so different from me; I just can't seem to connect with her." The nurse should plan to provide which intervention?

Counsel the mother regarding better ways to bond with her child

A child reports to the school nurse of being verbally bullied by an aggressive classmate. What is the nurses best first action?

Encourage the victimized child to share feelings about the experience

Which behavior is most indicative of a 4-year-old child diagnosed with Tourette's syndrome?

Frequent Eye Blinking

A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the nurse, What should we do? Select the nurses best response.

Give your child a kiss before you leave the preschool program

Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders

Impaired social interaction related to difficulty relating to others

A child diagnosed with attention deficit hyperactivity disorder (ADHD) shows hyperactivity, aggression, and impaired play. The health care provider prescribed amphetamine salts (Adderall). The nurse should monitor for which desired behavior?

Improved abilities to participate in cooperative play with other children

Assessment data for a 7-year-old reveals an inability to take turns, blurting out answers to questions before a question is complete, and frequently interrupting others conversations. How should the nurse document these behaviors?

Impulsivity

A nurse will prepare teaching materials for the parents of a child newly diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will the information focus on

Methylphenidate (Ritalin)

A child diagnosed with autism will demonstrate impaired development in which area?

Playing with other children

Child protective services have removed 10-year-old Christopher from his parents' home due to neglect. Christopher reveals to the nurse that he considers the woman next door his "nice" mom, that he loves school, and gets above average grades. The strongest explanation of this response is:

Resilience

Which factor can reduce the vulnerability of a child to etiological influences predisposing to the development of psychopathology?

Resilience

Which nursing diagnosis should be considered for a child with attention deficit hyperactivity disorder ADHD?

Risk for injury

What is the nurses priority focused assessment for side effects in a child taking methylphenidate (Ritalin) for attention deficit hyperactivity disorder (ADHD)?

Sleep disturbances and weight loss

Soon after parents announced they were divorcing, a child stopped participating in sports, sat alone at lunch, and avoided former friends. The child told the school nurse, If my parents loved me, they would work out their problems. Which nursing diagnosis has the highest priority?

Social isolation

A desired outcome for a 12-year-old diagnosed with attention deficit hyperactivity disorder (ADHD) is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care?

Social skills group

A 5-year-old who consistently omits the sound for 'r' and 's' when speaking is demonstrating which type of disorder?

Speech

When a 5-year-old diagnosed with attention deficit hyperactivity disorder (ADHD) bounces out of a chair and runs over and slaps another child, what is the nurses best action?

Take the aggressive child to another room.

When a nurse assesses the style of behavior a child habitually uses to cope with the demands and expectations of the environment, he or she is assessing characteristic?

Temperament

Which activity is most appropriate for a child with ADHD?

Tennis

Which assessment finding would cause the nurse to consider a child to be most at risk for the development of mental illness?

The child has been raised by a parent with chronic major depression

The parent of a child diagnosed with Tourettes disorder says to the nurse, I think my child is faking the tics because they come and go. Which response by the nurse is accurate?

Tics often change frequency or severity. That doesnt mean they arent real.

April, a 10-year-old admitted to inpatient pediatric care, has been getting more and more wound up and is losing self-control in the day room. Time-out does not appear to be an effective tool for April to engage in self-reflection. April's mother admits to putting her in time-out up to 20 times a day. The nurse recognizes that:

Time-out is no longer an effective therapeutic measure.

A 10-year-old who is frequently disruptive in the classroom begins to fidget and then moves on to disruptive behavior. What is the most appropriate initial technique for managing this sort of disruptive behavior?

Touch Control

The child prescribed an antipsychotic medication to manage violent behavior is one most likely diagnosed with:

attention deficit hyperactivity disorder.

The parent of a 6-year-old says, My child is in constant motion and talks all the time. My child isnt interested in toys but is out of bed every morning before me. The childs behavior is most consistent with diagnostic criteria for:

attention deficit hyperactivity disorder.

Which behavior indicates that the treatment plan for a child diagnosed with an autism spectrum disorder was effective? The child:

holds the parents hand while walking.

A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the childs disorder? The child:

continuously rocks in place for 30 minutes

A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter. The child formed a trusting relationship with a shelter volunteer. The child says, My three friends and I got an A on our school science project. The nurse can assess that the child:

displays resiliency

A child diagnosed with attention deficit hyperactivity disorder had this nursing diagnosis: impaired social interaction related to excessive neuronal activity as evidenced by aggression and demanding behavior with others. Which finding indicates the plan of care was effective? The child:

engages in cooperative play with other children

A kindergartener is disruptive in class. This child is unable to sit for expected lengths of time, inattentive to the teacher, screams while the teacher is talking, and is aggressive toward other children. The nurse plans interventions designed

reduce loneliness and increase self-esteem

When a 5-year-old is disruptive, the nurse says, You must take a time-out. The expectation is that the child will:

sit on the edge of the activity until able to regain self-control